The use of paclitaxel-resveratrol matrix-coated peripheral balloons compared to POBA was associated with a significantly reduced TLR rate, superior patency and substantial cost savings at 2 years. ClinicalTrials.gov Identifier NCT01970579.

The use of paclitaxel-resveratrol-matrix-coated peripheral balloon angioplasty as compared to POBA was associated with significantly reduced in-lesion LLL and reduced TLR rates. ClinicalTrials.gov identifier NCT01970579.

The Amplatzer Vascular Plug II (AVP II) is a novel device for transcatheter vessel occlusion, for which only limited comparative data exist. Embolotherapy of the gastroduodenal artery (GDA) is essential before internal radiotherapy (SIRT) in order to prevent radiation-induced peptic ulcerations due to migration of yttrium-90 microspheres. The purpose of this study was to compare the vascular anatomical limitations, procedure time, effectiveness, and safety of embolization of the GDA with coils versus the AVP II. Fifty patients stratified for SIRT were prospectively randomized for embolization of the GDA with either coils or the AVP II. The angle between the aorta and the celiac trunk, diameter of the GDA, fluoroscopy time and total time for embolization, number of embolization devices, complications, and durability of vessel occlusion at follow-up angiography for SIRT were recorded. A t-test was used for statistical analysis. Embolizations with either coils or the AVP II were technically feasible in all but two patients scheduled for embolization of the GDA with the AVP II. In both cases the plug could not be positioned due to the small celiac trunk outlet angles of 17 degrees and 21 degrees. The mean diameter of the GDA was 3.7 mm (range, 2.2-4.8 mm) for both groups. The procedures differed significantly in fluoroscopy time (7.8 min for coils vs. 2.6 min for the AVP II; P < 0.001) and embolization time (23.1 min for coils vs. 8.8 min for the AVP II; P < 0.001). A mean of 6.0 +/- 3.2 coils were used for GDA embolization, while no more than one AVP II was needed for successful vessel occlusion (P < 0.001). One coil migration occurred during coil embolization, whereas no procedural complication was encountered with the use of the AVP II. Vessel reperfusion was noted in only one patient, in whom coil embolization was performed. In conclusion, embolization of the GDA with the AVP II is safe, easy, rapid, and highly effective; only an extremely sharp-angled celiac trunk outlet represented an anatomical limitation for device deployment.

Below-the-knee PTA as an isolated part of therapy was effective to prevent major amputation in more than a half of diabetic patients with CLI. TcPO₂ was a valid predictor for limb salvage, even when angiographic outcome criteria failed.

A complete evaluation strategy had been developed for thoracic X-ray imaging. It has been validated by investigating five chest-radiography systems, two of these systems after optimising image processing. The systems were a screen-film combination, a selenium drum, a conventional and a transparent imaging plate and a Cs/I-based flat panel detector (the two latter ones have been optimised using different post processing). At first all detectors have been characterised using physical parameters like DQE and MTF. After that all systems have been evaluated by human observer studies using anatomy in clinical images (VGA, ICS) and added pathological structures in thoracic phantom images (ROC). The ranking of the image quality of the systems was nearly the same in all studies. There was a similar assessment of main image quality parameters like spatial resolution, dynamic range and MTF. The modification of image post processing changed the visibility of pathological structures more than the visualisation of the anatomical criteria. The assessment of the clinical image quality has to be done for anatomical structures, and the recognition of pathological structures has to be evaluated.

CTGB demonstrated superior local tumor control compared to ILT in long-term follow-up.

In addition to comparing the image quality of the different systems, this study shows that the performance of a radiographic system depends on the structure to be analyzed. The modified ROC (ms-ROC) provides valid results with less effort.

Zusammenfassung Hintergrund Nahtaneurysmen (NA) sind ein relevanter Aspekt der Sekundärversorgung geworden. Das Ziel der Studie bestand darin, bei Patienten eines zertifizierten Gefäßzentrums das Auftreten von NA im Rahmen einer retrospektiven Fallserie zu untersuchen und selektiv eruierten Referenzen der wissenschaftlichen Literatur gegenüberzustellen. Patienten und Methode Über einen definierten Untersuchungszeitraum wurden alle Patienten mit einem Leisten-NA hinsichtlich patientenabhängiger Faktoren (Alter, Geschlechtsverteilung), NA-Größe, chirurgischer Versorgung (Rhaphie ± Patch vs. Interponat) und Ergebnis (Offenheitsrate, NA-Rezidiv, Morbidität, Letalität) charakterisiert. Ergebnisse Die meisten NA traten nach Anlage einer aortobifemoralen Prothese (52,3 %) auf. Das durchschnittliche Zeitintervall bis zur NA-Entwicklung betrug 55,4 Monate. Über die Hälfte der NA (n = 44; 51,2 %) wurden primär mittels Interponat versorgt. – Die Aneurysmorrhaphie mit bzw. ohne Patch hat eine signifikant höhere Wahrscheinlichkeit für ein NA-Rezidiv im Vergleich zum Interponat (p = 0,026 bzw. p = 0,006). Der durchschnittliche Durchmesser der Leisten-NA betrug 46,4 mm. Bei den postoperativen Komplikationen waren am häufigsten nicht operationspflichtige Lymphozelen (25,6 %), Hämatome mit notwendiger Ausräumung (8,1 %) und Infektionen mit erforderlicher Explantation des alloplastischen Materials (4,7 %). Die 30-Tage-Letalität betrug 2,3 %. Die notfallmäßig versorgten NA wiesen eine tendenziell höhere Wahrscheinlichkeit einer postoperativen Komplikation (p = 0,09) auf. Schlussfolgerungen Nahtaneurysmen sind mit einer Inzidenz von 0,2–15 % keine seltene Komplikation in der Gefäßchirurgie. Die Interponatanlage ist die Therapie der Wahl bei der Versorgung der Leisten-NA. Alle Patienten sollten über die Wichtigkeit einer lebenslangen gefäßchirurgischen Nachsorge aufgeklärt werden.